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Licensing details for: 11104

Name: GUY W. MENDIVIL, D.D.S., PROF. DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

3998 Vista Way
SUITE B
OCEANSIDE CA 92056-4500
SAN DIEGO county
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Practice Location

3998 VISTA WAY
SUITE B
OCEANSIDE CA 92056
SAN DIEGO county
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Issuance Date

May 24, 2013

Expiration Date

November 30, 2020

Current Date / Time

June 7, 2025
8:48:30 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: MENDIVIL, GUY WILLIAM

License/Registration Type: Dentist License

License Number: 29737 Primary Status: Current - Active

Address :
11901 Bolthouse Dr
SUITE 200
BAKERSFIELD CA 93311-8455

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